Striking with the Root: Turmeric Curcumin & Ulcerative Colitis

Striking with the Root: Turmeric Curcumin & Ulcerative Colitis
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A double-blind, placebo-controlled trial found a dramatic effect of the anti-inflammatory spice pigment curcumin against inflammatory bowel disease.

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Despite evidence going back 40 years that the turmeric spice component, curcumin, possesses significant anti-inflammatory activity, it wasn’t until 2005 that it was first tested on inflammatory bowel disease. Why did it take so long? Well, who’s going to fund such a study? Big curry? But lack of corporate backing doesn’t stop individual doctors from giving it a try, which is what these New York physicians did. They decided to ask the next five patients that walked into the door with ulcerative colitis to start curcumin supplements.

Ulcerative colitis is a debilitating, chronic, relapsing-remitting—meaning it comes and goes—inflammatory bowel disease that afflicts millions. As with most diseases, we have a bunch of drugs to treat people, but sometimes these drugs can add to disease complications—most commonly nausea, vomiting, headaches, rash, fever, and inflammation of the liver, pancreas, and kidneys—as well as wiping out our immune system and fertility. Most ulcerative colitis patients need to be on drugs every day for the rest of their lives; so, we need something safe to keep the disease under control.

So, how’d they do on the spice extract? Overall, all five subjects improved by the end of the study—and four out of five were able to decrease or eliminate their meds. They had more formed stools, less frequent bowel movements, and less abdominal pain and cramping. One even reported decreased muscle soreness than they normally felt after their exercise routine. But this was what’s called an open label study, meaning that the patients knew that they were taking something; and so, some of the improvement may have just been the placebo effect. In 2013, another small open-label pilot study found encouraging results in a pediatric population, but what was needed was a larger scale, double-blind, placebo-controlled trial.

And here we go! They took a bunch of people with quiescent ulcerative colitis, and gave them either turmeric curcumin along with their typical anti-inflammatory drugs, or a placebo and their drugs. In the placebo group, eight relapsed, out of 39, meaning their disease flared back up. In the curcumin group? Only two, out of 43; significantly fewer. And relapse or not, clinically, the placebo group got worse, and the curcumin group got better. And endoscopically, objectively visualizing the inside of their colons, the same thing. A trend towards worse or better.

Five percent relapse rate in the curcumin group, 20% relapse rate in the just conventional care group. It was such a dramatic difference that the researchers wondered if it was some kind of fluke. Even though patients were randomized to each group, maybe through some chance coincidence the curcumin group just ended up being much healthier; and so, maybe it was some freak occurrence, rather than curcumin, that accounted for the results. So, what they did was they extended the study another six months, but put everyone on placebo. So, they stopped the curcumin to see if they’d then start relapsing too, and that’s exactly what happened. All of a sudden, they became just as bad as the sugar pill group.

Conclusion: Curcumin seems to be a promising and safe medication—no side effects at all reported—for maintaining remission in patients with quiescent ulcerative colitis. So, “Curry for the cure?” asked an accompanying editorial in the journal of the Crohn’s and Colitis Foundation of America. Can curcumin be added to our list of options with respect to maintaining remission in ulcerative colitis? What is noteworthy, as I mentioned, is the fact that not only did the authors demonstrate a statistically significant decrease in relapse at six months, but a statistically significant improvement in the endoscopic index as well. Equally telling is the fact that upon withdrawal of curcumin, the relapse rate quickly paralleled that of patients treated initially with placebo—implying that curcumin was, in fact, exerting some important biologic effect.

That’s the same thing a Cochrane review concluded in 2013: curcumin may be a safe and effective adjunct therapy. Cochrane reviews take all the best studies meeting strict quality criteria and compile all the best science together—normally a gargantuan undertaking, but not in this case, as there is really just that one good study.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to Jonathan Cohen / Flickr

Despite evidence going back 40 years that the turmeric spice component, curcumin, possesses significant anti-inflammatory activity, it wasn’t until 2005 that it was first tested on inflammatory bowel disease. Why did it take so long? Well, who’s going to fund such a study? Big curry? But lack of corporate backing doesn’t stop individual doctors from giving it a try, which is what these New York physicians did. They decided to ask the next five patients that walked into the door with ulcerative colitis to start curcumin supplements.

Ulcerative colitis is a debilitating, chronic, relapsing-remitting—meaning it comes and goes—inflammatory bowel disease that afflicts millions. As with most diseases, we have a bunch of drugs to treat people, but sometimes these drugs can add to disease complications—most commonly nausea, vomiting, headaches, rash, fever, and inflammation of the liver, pancreas, and kidneys—as well as wiping out our immune system and fertility. Most ulcerative colitis patients need to be on drugs every day for the rest of their lives; so, we need something safe to keep the disease under control.

So, how’d they do on the spice extract? Overall, all five subjects improved by the end of the study—and four out of five were able to decrease or eliminate their meds. They had more formed stools, less frequent bowel movements, and less abdominal pain and cramping. One even reported decreased muscle soreness than they normally felt after their exercise routine. But this was what’s called an open label study, meaning that the patients knew that they were taking something; and so, some of the improvement may have just been the placebo effect. In 2013, another small open-label pilot study found encouraging results in a pediatric population, but what was needed was a larger scale, double-blind, placebo-controlled trial.

And here we go! They took a bunch of people with quiescent ulcerative colitis, and gave them either turmeric curcumin along with their typical anti-inflammatory drugs, or a placebo and their drugs. In the placebo group, eight relapsed, out of 39, meaning their disease flared back up. In the curcumin group? Only two, out of 43; significantly fewer. And relapse or not, clinically, the placebo group got worse, and the curcumin group got better. And endoscopically, objectively visualizing the inside of their colons, the same thing. A trend towards worse or better.

Five percent relapse rate in the curcumin group, 20% relapse rate in the just conventional care group. It was such a dramatic difference that the researchers wondered if it was some kind of fluke. Even though patients were randomized to each group, maybe through some chance coincidence the curcumin group just ended up being much healthier; and so, maybe it was some freak occurrence, rather than curcumin, that accounted for the results. So, what they did was they extended the study another six months, but put everyone on placebo. So, they stopped the curcumin to see if they’d then start relapsing too, and that’s exactly what happened. All of a sudden, they became just as bad as the sugar pill group.

Conclusion: Curcumin seems to be a promising and safe medication—no side effects at all reported—for maintaining remission in patients with quiescent ulcerative colitis. So, “Curry for the cure?” asked an accompanying editorial in the journal of the Crohn’s and Colitis Foundation of America. Can curcumin be added to our list of options with respect to maintaining remission in ulcerative colitis? What is noteworthy, as I mentioned, is the fact that not only did the authors demonstrate a statistically significant decrease in relapse at six months, but a statistically significant improvement in the endoscopic index as well. Equally telling is the fact that upon withdrawal of curcumin, the relapse rate quickly paralleled that of patients treated initially with placebo—implying that curcumin was, in fact, exerting some important biologic effect.

That’s the same thing a Cochrane review concluded in 2013: curcumin may be a safe and effective adjunct therapy. Cochrane reviews take all the best studies meeting strict quality criteria and compile all the best science together—normally a gargantuan undertaking, but not in this case, as there is really just that one good study.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to Jonathan Cohen / Flickr

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